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General NPI Number Information
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NPI Number | 1801335435
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Entity Type | Individual
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Provider Name | PEDRO J RIVERA SR. RN
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Gender | Male
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 02/15/2017
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Provider Practice Location Address
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Address Line | 239 AVE ARTERIAL HOSTOS SUITE 806
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City | SAN JUAN
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State | PR
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Zip | 00918-1474
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Country | US
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Telephone | 787-536-0222
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Fax | 787-250-8156
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Provider Business Mailing Address
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Address Line | 239 AVE ARTERIAL HOSTOS SUITE 806
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City | SAN JUAN
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State | PR
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Zip | 00918-1474
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Country | US
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Telephone | 787-536-0222
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Fax | 787-250-8156
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number | 14797
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 14797
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License Number State | PR
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